help me understand my blood sugar!!!

[MeredithMommy]

I am 28 weeks pregnant. I had a mw appt today, and we tested my blood sugar with a glucometer. I ate 2 pancakes with syrup for breakfast 2 hours before the test, as per mw's instructions. My blood sugar level was 144. Mw said it's not high enough to be gd(170 or above), but that it really shouldn't be above 140.

Now I am totally worried about my blood sugar levels.

Mw said that the best thing I conld do was to control my diet (eat less sugar and carbs) and to exercise more. The thing is, I'm not sure how strict to be about my diet.

She also said that we will test blood sugar every appt just to be sure.

I was wondering if it would be a good idea (or totally un-necessary) for me to check my blood sugar at home for a week or so, just to see which foods make my blood sugar higher and which are ok.

I really don't know lots about this, so any input or advice would be totally appreciated.

thanks!!!

[RosesArePurple]

Originally Posted by MeredithMommy

I ate 2 pancakes with syrup for breakfast 2 hours before the test, as per mw's instructions. My blood sugar level was 144. Mw said it's not high enough to be gd(170 or above), but that it really shouldn't be above 140.

Now I am totally worried about my blood sugar levels.

Well, I have to say, that was an interesting way to test your levels. The only really good diagnostic to do the 3 hour GTT (don't if you don't want to!!!! It's a PITA!) which is a diagnostic test, whereas the 1 hour test is merely a screening with high false positives. So, if you get to avoid these, great!!!

She's right in that the blood sugar level at 2 hours is not optimal, but it's not horrible.

One really good site for gestational diabetes info is at Plus-Size-Pregnancy
She discusses numbers from a GD perspective.

Personally, I wouldn't sweat it. I have gestation diabetes and I can almost guarantee if I ate that breakfast, my 2 hour postprandial number would be 180 or probably even greater.

I would do as your provider suggests. Just let her test you once in a while. Don't test yourself and make yourself crazy since your number isn't *that* bad. If you aren't exercising, it only takes a 30 minute walk a day to help with sugar uptake, but you have to be consistent.

As far as your diet, I wouldn't sweat that either, but steer clear of simple carbs, sugar, white bread, white pasta and the like. Also, know this: if you had had some protein with your pancakes, your number would be lower, so...
If you want to eat something with refined carbs, make sure there's a protein there.

Like I said, I wouldn't sweat it too much. But the website I gave you will keep you in reading about GD and why you want to AVOID the diagnosis!!!!
I'm looking at a repeat scheduled C-Section for that and a few other stupid issues that are stacking up.:

And know this: some of this is actually normal. There are a lot of people who think GD is not a real disease, and it's treatment is not consistant from provider to provider. It has to be really bad to make a size effect on your baby.

Good Luck to you in you pregnancy!!!!!!

[Herausgeber]

Figuring out which foods will drive your sugar up to borderline levels isn't that hard; neither is avoiding them!

Just think unprocessed, whole grains, lots of proteins, fresh vegetables.

I declined the GD test, and instead spotcheck my own levels every once in a while after big meals. The worst offender? White rice.

[roadfamily6now]

i agree that is interesting. That is a lot of sugars and carbs to be eating just before a GD test.

It looks like you are fine, just watch the sugars.
Try to eat more protiens and vegies!

[lorijds]

Lots of practitioners test in that manner. In our office, we ask women to eat a 50 gram carb meal one hour before testing. We want to know how their bodies react to food, not just to an orange sugar drink that on any other day we wouldn't want them to be consuming anyhow. Some practices have different philosophies and have developed standards that reflect them.

144 is just shy of high. The diet advice that you have been given is good. Reduce your simple (refined and unrefine) sugar intake; combine all sugars with high amounts of protein and complex carbs. If your weight gain isn't excessive for you, if you feel well, and if your urine dips are fine, then tweaking your diet should be fine.

Just a note, though, alot of newer research is indicating a link between GD and adult onset diabetes. Actually, some of the newer research questions whether there *is* such a thing as GD, if when we see higher blood sugars in pregnant women, what we are seeing is Type II diabetes; just that when the body is stressed by pregnancy, we see the higher blood surgars, and they are signs of impending type II. That the indicators of type II pop up in certain situaions--pregnancy and short term steroid use being two that are probably most frequent.

Meaning that if you develop GD while you are pregnant, you have a much greater risk of developing Type II diabetes when you are middle aged. The good thing is that Type II can be controlled by diet and exercise in many people, so knowing that you have a predisposition for it, for whatever reason, gives you the knowlege and power you need to make positive lifestyle changes now that will make you heatheir for the rest of your life.

[RosesArePurple]

Originally Posted by lorijds

Just a note, though, alot of newer research is indicating a link between GD and adult onset diabetes. Actually, some of the newer research questions whether there *is* such a thing as GD, if when we see higher blood sugars in pregnant women, what we are seeing is Type II diabetes; just that when the body is stressed by pregnancy, we see the higher blood surgars, and they are signs of impending type II. That the indicators of type II pop up in certain situaions--pregnancy and short term steroid use being two that are probably most frequent.

This is very interesting. And also a bit disturbing to me. I had been reading during my GD saga about my 50% chance of developing Type II later, as in GD is not the same as Type II but can be a precursor, and how exercise can help stave it off. My diet in general is very good, but I do need to exercise more : But if it's true that GD *is* Type II, then oh my I have more incentive to exercise more. (I do exercise now, as much as my pregnant body will allow, but I had really slacked off pre-pregnancy)

[CEG]

I have never heard of that method of testing. Good, in the sense that it's not really realistic to drink that much sugary drink. Bad in the sense that it may be less than precise- I drown my pancakes in butter and syrup, while someone else may just put a little on. Just my .02.

Anyway, I was discussing GD with a midwife the other day and the risks she peceived- lung immaturity and big baby being the biggest. What was interesting to me is that she said GD babies actually tend not just to be fatter, but also have wider shoulder girth, thus increasing the risk of shoulder dystocia over a non-GD same weight baby.

During pregnancy a woman's cells become more insulin resistant, increasing the amount of glucose available in her blood to the baby. The baby produces it's own insulin, so too much sugar puts a burden on the baby to produce more insulin. Actually it's interesting as both are immune related. Diabetes is considered auto-immune- self destruction of pacreatic cells. During pregnancy the immune system changes to allow acceptance of the foriegn cells of the baby which has other effects including the increased insulin resistance. Fascinating what our bodies know how to do.

[maxmama]

Originally Posted by CEG

During pregnancy a woman's cells become more insulin resistant, increasing the amount of glucose available in her blood to the baby. The baby produces it's own insulin, so too much sugar puts a burden on the baby to produce more insulin. Actually it's interesting as both are immune related. Diabetes is considered auto-immune- self destruction of pacreatic cells. During pregnancy the immune system changes to allow acceptance of the foriegn cells of the baby which has other effects including the increased insulin resistance.

Well, sort of.

In Type I diabetes, there is an autoimmune response that destroys the pancreatic islet cells that produce insulin. No insulin = high blood sugars. But in Type II or GDM, the pancreas is stlll there, works just fine, but the level of insulin resistance from the body's cells requires more insulin than the pancreas produces. The insulin resistance is the issue, not an autimmune response.

It's not really a strain on the fetus to make insulin. The issue is that their pancreases become accustomed to pumping out a boatload of insulin and can have trouble in the immediate postpartum adjusting to the lower level of glucose. They do figure it out, but in the meantime can have very low blood sugars (including seizure level), and are more susceptible to jaundice, which can make them not eat well, which makes their sugars more unstable, yada yada yada.

If your sugars are well-controlled in pregnancy (either via diet or insulin or both), then the risk of big babies and of neonatal hypoglycemia is much lower. One thign to watch for is that your sugars stay stable in labor, since it's a lot of stress (which raises your sugars) but also a lot of exercise (which lowers them), and if you can keep your sugars stable just before the baby's born it reduces the chance of immediate hypoglycemia.

[gardenmom]

Subscribing to the thread, as I had a high reading (152) of a non-fasting 1 hour test and my midwife wants me to take the 3 hour GTT soon, blech. I'm hoping that I am one of those who had a false positive, but I'll know soon enough.

Does anyone know if having the 1 hour test late (week 29) affects the results?

Thanks for all the great information here...will keep checking in.

[RosesArePurple]

Originally Posted by gardenmom

Subscribing to the thread, as I had a high reading (152) of a non-fasting 1 hour test and my midwife wants me to take the 3 hour GTT soon, blech. I'm hoping that I am one of those who had a false positive, but I'll know soon enough.

Does anyone know if having the 1 hour test late (week 29) affects the results?

Thanks for all the great information here...will keep checking in.

That doesn't seem to be horribly high to me. Having the test one week late wouldn't really affect the results, my Endocrinologist told me that as your pregnancy goes on, your hormones increase, making it harder on your sugar levels, until the 36th week when hormone levels level out. So it's actually possible, the further out you test, the worse your test results will be if you have GD.

I'm sorry you may go through the 3 hour GTT. Here's hoping you will do fine and don't have GD!!!!

[MeredithMommy]

thanks for the responses ladies!

I feel a little better now that I've had some time to think about all this.

Should I be doing the urine ketone test strips??? My midwife doesn't do them at my appts, should I ask her to?

I just don't want to put my baby or myself at risk.

thanks.

[RosesArePurple]

Originally Posted by MeredithMommy

thanks for the responses ladies!

I feel a little better now that I've had some time to think about all this.

Should I be doing the urine ketone test strips??? My midwife doesn't do them at my appts, should I ask her to?

I just don't want to put my baby or myself at risk.

thanks.

You really only need to do ketone sticks if you are on a diabetic diet. They are checking for "starvation ketosis" because sometimes the diet is quite restrictive.

Are you thinking about the protein sticks a lot of providers have you pee on? That's for pre-eclampsia. And there are other symptoms of that, severe edema, high blood pressure.

[MeredithMommy]

back again...more questions...........

We had an u/s today. Dh really wanted to know sex of baby, and I just wanted to check up on baby, so mw ordered one for us.

I am supposed to be 29w 1 day, due dec 5, the tech did the head circumfrence thing and said that it put me due nov 28.

Baby is also 3lb 6oz at this point, about 2 weeks ahead of average.

At this point baby will still only gain about 1/2 lb a week right??? So that *should* put baby at 9lbs, give or take some, at birth.

do you think my blood sugar being slightly/moderately high is causing baby to be bigger than average at this point??? I mean I'm all for big babies, but the thought af a 12lb future linebacker coming out of my nether regions is kind of scary

[RosesArePurple]

Originally Posted by MeredithMommy

I am supposed to be 29w 1 day, due dec 5, the tech did the head circumfrence thing and said that it put me due nov 28.

Baby is also 3lb 6oz at this point, about 2 weeks ahead of average.

At this point baby will still only gain about 1/2 lb a week right??? So that *should* put baby at 9lbs, give or take some, at birth.

do you think my blood sugar being slightly/moderately high is causing baby to be bigger than average at this point??? I mean I'm all for big babies, but the thought af a 12lb future linebacker coming out of my nether regions is kind of scary

Wow! Well first off, from what I remember, due date calculations from U/S past a few weeks are not accurate at all. Do not let them push up your due date in today's "You can't go past 42 weeks without induction" climate.

Secondly, U/S poundage estimates can be off by as much as two pounds, so do not let this bother nor worry you. You just won't know the weight until after the baby is born.

Thirdly, it's my understanding that real actual macrosomia babies would only happen with rampant un-treated diabetes. So I doubt your baby is "big" because of that, unless you are eating nothing but sugar all day.

If you are worried, just cut out all your simple carbs/sugars for the rest of your pregnancy. That way you aren't feeding the baby a bunch of glucose to use to pack on weight. Go peruse Plus-Size-Pregnancy's web site for GD information. She has a ton of really good information that may put your mind at ease.

And there are birth stories here that will let you know that birthing a 10 pounder can be done! And 9 pounders are done ALL the time!

[boscopup]

Originally Posted by MeredithMommy

I am supposed to be 29w 1 day, due dec 5, the tech did the head circumfrence thing and said that it put me due nov 28.

Baby is also 3lb 6oz at this point, about 2 weeks ahead of average.

Here's an intrauterine growth chart that should make you feel better. (yes, you need to convert lbs/grams)

I had an u/s with last baby at 29w1d and it said he was 3 lbs 10 oz. He was born 3 days later at 3 lbs 13 oz (so the u/s was pretty much right on). According to the growth chart, he would have only been about 8.5 lbs at 40 weeks. And no, I had NO blood sugar issues. I just grow slightly bigger than average babies - not huge 12 lbers or anything.

My current baby was measuring 2 weeks ahead on u/s at 20 weeks. I figure he'll probably be right around 9 lbs (unfortunately, I've never found a growth chart that starts before 28 weeks). Again, not huge - just bigger than average. I have checked my blood sugar periodically (I refused the GTT), and it ranged from 91-95, 2 hours post meal. That's perfectly normal. So no GD problems here.

I think you should monitor your blood sugar and eat a diabetic-friendly diet, but it doesn't sound like your baby is huge as of yet.

[gardenmom]

Originally Posted by MeredithMommy

We had an u/s today. Dh really wanted to know sex of baby, and I just wanted to check up on baby, so mw ordered one for us...
l

Meredith, my personal experience with the u/s during my last pregnancy is that they can be waaaaaay off. At hospital (prior to induction) at 42 weeks with dd, they were putting her weight around 8 pounds, similar to the mw's office sono at about 40 weeks. DD was born at 9lb. 10oz.

I agree with RosesArePurple--under no circumstances should you allow them to adjust your due date to a closer date based on the ultrasound. The last thing you need is a forced induction at 2 weeks past an early (wrong) due date. My own ultrasound put me about 3 days earlier than my Nov 28th date, and the mw specifically said she would NEVER push the date closer, especially based on my past due/induction/c-sec history with dd.

Women give birth to big kids all the time..dh and his brother are both big guys..they were both over 11 lbs and birthed vaginally. My Dad recently told me that someone in his family was over 12 lbs at birth, (which I suspect was actually due to Grandma having high sugar/gd and not knowing it back then). Grandma was about 5 feet tall, and I imagine normal to thin in weight at that time.

You can do it!